Provider Contracting Manager

Zing Health • IL

77d

About The Position

The Provider Contracting Manager will manage physician contracting and network development for an assigned region. The Provider Contracting Manager is responsible for developing and maintaining cooperative working relationships with the provider community; educating, training, researching issues; and identifying trends and evaluating providers to ensure contractual and financial requirements are adhered to and performed.

Requirements

• Medicare Experience Preferred
• 3 - 5 years of experience in a Managed Care environment, Network Management or Provider Services
• Hospital contracting experience or related Network Management position with the ability to perform the level of duties of the position
• Demonstrated negotiation, analytic, and problem-solving skills
• Experience or knowledge of provider reimbursement methods and claims processing systems
• Verbal and written communications skills to include interpersonal and presentation skills
• Ability to work effectively and independently. Demonstrated ability to effectively manage multiple priorities

Responsibilities

• Contracts and negotiates with Hospital, FQHCs, Physicians and Ancillary providers for all product lines
• Conducts Provider Orientations and ongoing education to Network Providers
• Understands and explains fee-for-service and risk contracts
• Manages physician network by developing and maintaining relationships to drive business results within a specific geographic area
• Responds to provider’s contract requests and inquiries
• Analyzes network gaps and identifies providers to contract
• Reviews and amends provider’s contracts when necessary
• Evaluates contracted network to ensure functionality
• Research and develop relationships with non-contracted providers
• Collects credentialing and required documents for newly contracted providers
• Performs special projects as assigned

Benefits

• A competitive salary based on the market
• Medical, Dental, and Vision
• Employer-Paid Life Insurance
• 401(K) match up to 4%
• Paid-Time-Off
• Several supplemental benefits are available, including, but not limited to, Spouse Insurance, Pet Insurance, Critical Illness coverage, ID Protection, etc.

What This Job Offers

• Career Level: Mid Level
• Education Level: Bachelor's degree